10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Antimicrobial stewardship: knowledge, attitudes and practices regarding antimicrobial use and resistance among non-healthcare students at the University of Zambia

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Antimicrobial resistance (AMR) poses a significant threat to the world and could become humanity's next major challenge. This study assessed non-healthcare students’ knowledge, attitude and practices (KAP) towards antimicrobial use (AMU) and AMR at the University of Zambia.

          Methods

          This cross-sectional study was conducted among 443 non-healthcare students from August to October 2022 using a structured questionnaire. Data analysis was done using IBM SPSS version 24.0.

          Results

          Of the 433 participants, 55.2%, 63.5% and 45% had moderate KAP scores regarding AMU and AMR. The prevalence of self-medication with antibiotics was 76.7%. Male participants were less likely to have good knowledge (OR = 0.524, 95% CI: 0.347–0.792) and positive attitudes (OR = 0.585, 95% CI: 0.364–0.940) towards AMU and AMR compared with females. Students who were studying Engineering and Mining were more likely to have good knowledge of AMR (OR = 1.891, 95% CI: 1.197–2.987) compared with those in Social Sciences. Those who were in their fourth and fifth years were more likely to have positive attitudes towards AMU and AMR (OR = 1.851, 95% CI: 1.147–2.986) compared with those who were in the first, second and third years. Finally, students who practised self-medication were less likely to have good self-reported practice towards AMR (OR = 0.442, 95% CI: 0.278–0.702) compared with those who did not.

          Conclusions

          This study demonstrated that non-healthcare students had moderate KAP regarding AMU and AMR. All university students should be provided with education about AMU and AMR through free short courses, seminars, workshops, and AMR and antimicrobial stewardship awareness campaigns.

          Related collections

          Most cited references113

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis

          (2022)
          Summary Background Antimicrobial resistance (AMR) poses a major threat to human health around the world. Previous publications have estimated the effect of AMR on incidence, deaths, hospital length of stay, and health-care costs for specific pathogen–drug combinations in select locations. To our knowledge, this study presents the most comprehensive estimates of AMR burden to date. Methods We estimated deaths and disability-adjusted life-years (DALYs) attributable to and associated with bacterial AMR for 23 pathogens and 88 pathogen–drug combinations in 204 countries and territories in 2019. We obtained data from systematic literature reviews, hospital systems, surveillance systems, and other sources, covering 471 million individual records or isolates and 7585 study-location-years. We used predictive statistical modelling to produce estimates of AMR burden for all locations, including for locations with no data. Our approach can be divided into five broad components: number of deaths where infection played a role, proportion of infectious deaths attributable to a given infectious syndrome, proportion of infectious syndrome deaths attributable to a given pathogen, the percentage of a given pathogen resistant to an antibiotic of interest, and the excess risk of death or duration of an infection associated with this resistance. Using these components, we estimated disease burden based on two counterfactuals: deaths attributable to AMR (based on an alternative scenario in which all drug-resistant infections were replaced by drug-susceptible infections), and deaths associated with AMR (based on an alternative scenario in which all drug-resistant infections were replaced by no infection). We generated 95% uncertainty intervals (UIs) for final estimates as the 25th and 975th ordered values across 1000 posterior draws, and models were cross-validated for out-of-sample predictive validity. We present final estimates aggregated to the global and regional level. Findings On the basis of our predictive statistical models, there were an estimated 4·95 million (3·62–6·57) deaths associated with bacterial AMR in 2019, including 1·27 million (95% UI 0·911–1·71) deaths attributable to bacterial AMR. At the regional level, we estimated the all-age death rate attributable to resistance to be highest in western sub-Saharan Africa, at 27·3 deaths per 100 000 (20·9–35·3), and lowest in Australasia, at 6·5 deaths (4·3–9·4) per 100 000. Lower respiratory infections accounted for more than 1·5 million deaths associated with resistance in 2019, making it the most burdensome infectious syndrome. The six leading pathogens for deaths associated with resistance (Escherichia coli, followed by Staphylococcus aureus, Klebsiella pneumoniae, Streptococcus pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa) were responsible for 929 000 (660 000–1 270 000) deaths attributable to AMR and 3·57 million (2·62–4·78) deaths associated with AMR in 2019. One pathogen–drug combination, meticillin-resistant S aureus, caused more than 100 000 deaths attributable to AMR in 2019, while six more each caused 50 000–100 000 deaths: multidrug-resistant excluding extensively drug-resistant tuberculosis, third-generation cephalosporin-resistant E coli, carbapenem-resistant A baumannii, fluoroquinolone-resistant E coli, carbapenem-resistant K pneumoniae, and third-generation cephalosporin-resistant K pneumoniae. Interpretation To our knowledge, this study provides the first comprehensive assessment of the global burden of AMR, as well as an evaluation of the availability of data. AMR is a leading cause of death around the world, with the highest burdens in low-resource settings. Understanding the burden of AMR and the leading pathogen–drug combinations contributing to it is crucial to making informed and location-specific policy decisions, particularly about infection prevention and control programmes, access to essential antibiotics, and research and development of new vaccines and antibiotics. There are serious data gaps in many low-income settings, emphasising the need to expand microbiology laboratory capacity and data collection systems to improve our understanding of this important human health threat. Funding Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            How to Calculate Sample Size for Different Study Designs in Medical Research?

            Calculation of exact sample size is an important part of research design. It is very important to understand that different study design need different method of sample size calculation and one formula cannot be used in all designs. In this short review we tried to educate researcher regarding various method of sample size calculation available for different study designs. In this review sample size calculation for most frequently used study designs are mentioned. For genetic and microbiological studies readers are requested to read other sources.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Antimicrobial resistance: a global multifaceted phenomenon.

              Antimicrobial resistance (AMR) is one of the most serious global public health threats in this century. The first World Health Organization (WHO) Global report on surveillance of AMR, published in April 2014, collected for the first time data from national and international surveillance networks, showing the extent of this phenomenon in many parts of the world and also the presence of large gaps in the existing surveillance. In this review, we focus on antibacterial resistance (ABR), which represents at the moment the major problem, both for the high rates of resistance observed in bacteria that cause common infections and for the complexity of the consequences of ABR. We describe the health and economic impact of ABR, the principal risk factors for its emergence and, in particular, we illustrate the highlights of four antibiotic-resistant pathogens of global concern - Staphylococcus aureus, Klebsiella pneumoniae, non-typhoidal Salmonella and Mycobacterium tuberculosis - for whom we report resistance data worldwide. Measures to control the emergence and the spread of ABR are presented.
                Bookmark

                Author and article information

                Contributors
                Journal
                JAC Antimicrob Resist
                JAC Antimicrob Resist
                jacamr
                JAC-Antimicrobial Resistance
                Oxford University Press (US )
                2632-1823
                December 2023
                07 November 2023
                07 November 2023
                : 5
                : 6
                : dlad116
                Affiliations
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Surveillance and Research Technical Working Group, Antimicrobial Resistance, Zambia National Public Health Institute , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Medicines Control, Zambia Medicines Regulatory Authority , Lusaka, Zambia
                Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University , Ndola, Zambia
                Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University , Ndola, Zambia
                College of Public Health, Zhengzhou University , 100 Kexue Avenue, Zhengzhou, Henan 450001, China
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Clinical Pharmacy, School of Pharmacy, Sefako Makgatho Health Sciences University , Pretoria, South Africa
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, Levy Mwanawasa Medical University , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, Levy Mwanawasa Medical University , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Laboratory of Pharmacology and Toxicology, University of Abomey-Calavi and Teaching Hospital of Abomey-Calavi/Sô-Ava , Abomey-Calavi, Benin
                Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi , Cotonou, Benin
                Department of Pharmacy, School of Health Sciences, University of Zambia , Lusaka, Zambia
                Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University , Multan, Pakistan
                Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT, UK
                Author notes
                Corresponding author. E-mail: steward.mudenda@ 123456unza.zm
                Author information
                https://orcid.org/0000-0003-1692-8981
                https://orcid.org/0000-0001-9490-5609
                https://orcid.org/0000-0001-9921-7039
                Article
                dlad116
                10.1093/jacamr/dlad116
                10635582
                37954639
                649585c9-e9d6-4329-a37e-d1b296186e9b
                © The Author(s) 2023. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 July 2023
                : 19 October 2023
                Page count
                Pages: 10
                Categories
                Original Article
                AcademicSubjects/MED00740
                AcademicSubjects/SCI01150

                Comments

                Comment on this article